American Chinese Journal of Medicine and Science最新文献

{"title":"Solitary Intracranial Plasmacytoma Located in the Clivus: A Diagnostic and Theraputic Challenge","authors":"Yunguang Liu, Jingxin Qiu","doi":"10.7156/NAJMS.2012.054232","DOIUrl":"https://doi.org/10.7156/NAJMS.2012.054232","url":null,"abstract":"Solitary intracranial plasmacytoma (SIP) is a rare entity.  To date, only 20 cases of SIP have been reported in English literature.  Occasionally, SIP is comprised of atypical plasma cells which may not be plasma cell-appearing at all.  As a result, pathologic diagnosis is extremely challenging, especially on frozen sections.  A recent case demonstrating this profile is reported here.  The patient was a 40-year-old white male who originally presented with diplopia.  MRI revealed an enhancing non-infiltrating mass (5 x 4 x 3 cm) within the clivus.  A transnasal endoscopic biopsy was done.  Frozen sections showed sheets of pleomorphic cells with abundant eosinophilic cytoplasm and round/oval nuclei with stippled chromatin. On touch prep, naked nuclei with homogenous/salt and pepper chromatin, mild crush artifacts and rare plasmacytoid cells were noted.  A frozen section diagnosis of \"unclassified neoplasm, defer to permanent sections\" was made.  Immunohistochemical analysis on permanent sections showed that tumor cells were positive for CD138, CD56, kappa light chain, BCL-1 and negative for chromogranin A and lambda light chain.  The Ki67 proliferation index was 5-10%.  The immunostaining pattern was consistent with plasmacytoma.  A subsequent complete work up for systemic disease revealed normal bone marrow biopsy, normal flow cytometry, and negative skeletal survey.  The patient did have a serum M-spike of 0.75 g/dL but his quantitative immunoglobulins, kappa or lamda free light chains and beta-2 microglobulin were within normal limits.  The patient was treated by radiation therapy accompanied by high-dose dexamethasone.  However, four months post-radiation, repeat MRI showed a similar mass in the same area.  His serum M-spike had dropped to 0.3 g/dL during his radiation therapy, but persisted at this level subsequently.  The diagnosis of persistent residual plasmacytoma was reached.  The patient underwent gamma knife radiosurgery and tolerated the procedure well.  This case demonstrated that SIP should be considered as one of the differential diagnoses for intracranial tumor of unknown origin.","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129836318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent Advances in Renal Cell Carcinoma Associated with Xp11.2 Translocations/TFE Gene Fusions","authors":"Yunguang Liu, Bo Xu, Frank Chen","doi":"10.7156/V5I1P043","DOIUrl":"https://doi.org/10.7156/V5I1P043","url":null,"abstract":".B Renal cell carcinoma associated with Xp11.2 translocations/TFE gene fusions (Xp11.2 RCC) has been classified as a distinct entity in the 2004 WHO classification of kidney tumors. Over the past seven years, aided by increased awareness, positive nuclear staining for TFE3, unique cytogenetic features, and modern molecular technology, more cases have been recognized as Xp11.2 RCC. This review summarizes the most recent advances in Xp11.2 RCC regarding to its clinical presentation, cytogenetic profile, histopathology, prognosis and treatment. (N A J Med Sci. 2012;5(1):43-47.)","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123915465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Myofibroblastoma of Breast and Its Most Common Mimickers","authors":"Ying Huang, Frank Chen","doi":"10.7156/V5I1P038","DOIUrl":"https://doi.org/10.7156/V5I1P038","url":null,"abstract":"Myofibroblastoma (MFB) is characterized as a benign stromal neoplasm composed of uniform, bland-looking spindle cells that are often arranged in fascicles separated by thick band of collagenous stroma.  Variable cellularity is common.  Immunohistochemically, the spindle cells are positive for CD34, vimentin, BCL-2, ER, PR, focally positive for smooth muscle actin and negative for cytokeratin, S-100 and CD117.  Although classic MFB is typically a bland-looking spindle cell tumor, some unusual morphologic variants may show worrisome malignant-looking cells. Recognition of MFB variants and its wide variety of mimickers is very important for pathologists to arrive at the correct diagnosis, and avoid misdiagnosis of malignancy.","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132037521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Stereotactic Body Radiation Therapy for the Treatment of Stage I Non-Small Cell Lung Cancer","authors":"R. Mak","doi":"10.7156/V4I1P089","DOIUrl":"https://doi.org/10.7156/V4I1P089","url":null,"abstract":"The standard of care for the treatment of early-stage nonsmall cell lung cancer is surgical resection. However, many patients with this disease have other medical comorbidities, which may preclude them from undergoing a surgical procedure. In these patients, conventional fractionated radiation therapy over 6-8 weeks has historically resulted in poor outcomes. The development of stereotactic body radiation therapy, a new form of very precise radiation therapy that delivers high doses of radiation in as few as 1 to 5 treatments to the tumor, provides these patients with a promising new alternative. Several phase II studies have demonstrated high local control rates of greater than 80-90% with this approach, and a low risk of severe toxicity (<10%) when patients are appropriately selected. Further study is required to examine the optimal candidates for this treatment and to further refine the technique, but stereotactic body radiation therapy is emerging as a promising, noninvasive treatment for stage I non-small cell lung cancer. [N A J Med Sci. 2011;4(2):89-92.]","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":" 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113950734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis of Hepatitis B Virus (HBV)-Mediated Liver Injury","authors":"Xuanyong Lu","doi":"10.7156/V4I1P001","DOIUrl":"https://doi.org/10.7156/V4I1P001","url":null,"abstract":"As a “stealth” virus, hepatitis B virus (HBV) is not directly cytopathic for infected hepatocytes. Hepatic injury is due primarily to the response of the body’s immune system to either acute or chronic infection with HBV. In general, two types of host’s responses occur to viral infection, i.e., innate immune response and adaptive immune response. Current evidence suggests that the innate immune response does not play an important role either in HBV clearance or in liver injury. In contrast, the adaptive immune response mediated by cytotoxic T-lymphocyte (CTL) cells is kinetically associated with viral clearance and liver injury. This observation suggests that the pathogenesis of HBV is closely related to the CTL-mediated immune response. One important way in which CTL cells mediate viral clearance is to secrete serine protease granzymes such as granzyme A and granzyme B which lead to the apoptosis of infected cells. However, HBV replication can upregulate the expression of apoptosis inhibitors such as serine protease inhibitor Kazal, or SPIK, resulting in the resistance of the cells to CTL-mediated immune killing. The inability of the immune system to clear HBV-infected cells can lead to chronic hepatitis B and development of HBV cirrhosis and hepatocellular carcinoma.","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128141892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secretory Leukocyte Protease Inhibitor: Immunohistochemical Evidence Supporting a Fallopian Tube Origin for Serous Papillary Carcinoma","authors":"Jianian Sun, A. Sands, Frank Chen, W. Mojica","doi":"10.7156/V2I1P042","DOIUrl":"https://doi.org/10.7156/V2I1P042","url":null,"abstract":"2-3 In this theory, the ovarian surface epithelium (OSE), usually flattened with no distinct features, undergoes Mullerian metaplasia and through possible undefined molecular events, acquires serous papillary morphology during malignant transformation. A contrasting opinion is that SPC may arise from the fallopian tube (FT), this supposition based on the morphologic resemblance of SPC to the fimbriated end of the FT. A recent report 4 investigating the patterns of gene expression among different histotypes of epithelial ovarian cancer showed strong correlation of expression profile of serous papillary carcinoma with that of the fallopian tube. Protein expression profiling by immunohistochemistry provides a straightforward method to delineate the tissue origin of cancer cells, and is the basis for panels of antibodies used in the work up of tumors of unknown origin. The differential expression of proteins can similarly be exploited to help establish the origin of tumors of ambiguous origin. Proteins expressed in non-malignant cells may continue to be expressed in their malignant counterparts. Thus, cell lineage can be extrapolated by examining protein expression in nonmalignant cells (e.g., FT or OSE) and their purported malignant counterpart (SPC). We have used this strategy with an antibody to Secretory Leukocyte Protease Inhibitor (SLPI), a 12-kDa protein found in various fluids including parotid secretions, cervical mucus, seminal plasma, ascites, and amniotic fluid. A potent inhibitor of human leukocyte elastase, SLPI is also shown to inhibit cathepsin G and trypsin. Previously it had been demonstrated that SLPI is expressed in FT tissue by Western blot analysis, RT-PCR and immunohistochemistry. 4 The aim of this study was to further characterize the expression of SLPI and examine its utility in the assessment of the cell lineage for SPC. Experimental design and methods Nine separate cases of formalin fixed, paraffin embedded tissue blocks containing the fimbriated end of the FT, nine cases of ovarian tissue with intact OSE, and nine cases of ovarian SPC were selected from the archival files of the Department of Pathology. Slides were prepared using standard antigen retrieval techniques and stained using a monoclonal antibody to SLPI (Santa Cruz, CA; titer of 1:100) and an avidin-biotin detection kit.","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122362068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of Functional MRI Guided Transcranial Magnetic Stimulation for Autism","authors":"Xuejun Kong","doi":"10.7156/V2I1P064","DOIUrl":"https://doi.org/10.7156/V2I1P064","url":null,"abstract":"Autism is a complicated neurodevelopment disorder of largely unknown cause. It is characterized by the difficulty to communicate and interact with others, often accompanied by significant behavioral challenges. Autism is much more common than previously believed. Based on the 2007 CDC data, 1 validated by several other recent epidemiologic studies, 2-3 autism is diagnosed in 1 in 150  children in the United States and it affects four times as many boys than girls. The diagnosis of autism has increased ten-fold in the last decade.  About 1.5 million Americans may have some form of autism when symptoms of milder variants are taken into consideration. This number continues to rise. Epidemiologists estimate that the number of autistic children in theUS could reach up to 4 million in the next decade. The Centers for Disease Control and Prevention has called autism a national public health crisis with an estimated cost of over $90 billion a year. Despite the serious social impact of autism, study grants available for research is reported to be only 0.3% of the total NIH funding, much lower than what is available for other less common and less severe disorders.","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"359 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115182445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Carcinosarcoma of Bone: A Case Report with Review of the Literature","authors":"T. Paczos, B. Mcgrath, Frank Chen","doi":"10.7156/V2I1P051","DOIUrl":"https://doi.org/10.7156/V2I1P051","url":null,"abstract":"Primary carcinosarcoma of the bone is an extremely rare entity with only a few other cases reported in the literature. Here we describe such a neoplasm in a 63year-old Caucasian male who presented with back pain and a pathologic fracture of T10 with lesions at T11, T12, and L1. A CT scan was done which showed a lytic lesion in the right posterior body of T11 measuring 2.2 cm. The patient had an open biopsy of this lesion that revealed a poorly differentiated spindle cell neoplasm. Microscopically, the lesion consists of a malignant spindle cell proliferation with marked nuclear pleomorphism, nuclear hyperchromasia, and an increased N/C ratio with some multinucleated forms present. Mitotic figures and atypical mitotic figures are also noted. Immunohistochemical analysis shows that the tumor cells are positive for Vimentin, CAM 5.2, and focally positive for low-molecular weight cytokeratin and high molecular weight cytokeratin. The tumor cells are negative for S100, HMB45, melan A, SMA, muscle specific actin, desmin, pancytokeratin, EMA, CD31, CD34, CD30, Alk1, TTF-1, calretinin, BerEP4, and thyroglobulin. The tumor cells are also negative for mucicarmine and alician blue pH 2.5. The morphology along with the immunohistochemical profile of the tumor is diagnostic for carcinosarcoma. Further workup revealed lesions in his right hip and left rib, but no other non-osteologic source for a primary lesion. The patient’s past medical history includes a resection of a scapular tumor 15 years ago that was diagnosed as low-grade chondosarcoma. These slides were reviewed and appear unrelated to the current diagnosis. The patient is currently undergoing chemotherapy with no new disease after 10 months. A literature review showed cases with similar morphologic and immunohistochemical features to this case. [N A J Med Sci. 2009;2(2):51-54.]","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116822210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Incidences of Gastric Cardiac- gastroesophageal Junctional and Sub-cardiac Carcinomas in Nanjing of China: A 20-year Retrospective Study from a Single Tertiary Medical Center","authors":"Li-hua Zhang, Qin Huang","doi":"10.7156/V2I1P035","DOIUrl":"https://doi.org/10.7156/V2I1P035","url":null,"abstract":"Background: The incidence of gastric cancer is decreasing worldwide in recent decades, which is credited to higher living standers and improved healthcare. It remains unclear whether it is true in the mainland China where rapid industrialization has been taken place over the past 30 years. The aim of this study was to investigate the relative and absolute incidence of gastric cardiac cancer occurring in the gastric cardiac-gastroesophageal junctional (GCG) and sub-cardiac (GSC) regions in the Nanjing metropolitan area of China over a 20-year period. Materials and Methods: Patient pathology reports were reviewed for the diagnosis of adenocarcinoma on gastroduodenoscopic biopsies collected from 1982 through 2001. All reports and corresponding histology slides were retrieved and reviewed to confirm the diagnosis and tumor locations. The patients were subgrouped into 5 time segments, ie, 1982-1985, 1986-1989, 1990-1993, 1994-1997, and 1998-2001. Within each segment, we collected and analyzed statistically the data on tumor locations (GCG vs GSC), patients’ ages and sexes over time. Results: Among 123,472 gastric adenocarcinomas diagnosed during this 20-year period, 5275 (4.3%) were in the cardiac region with 1885 (35.7%) GCG and 3390 (64.3%) GSC cases, respectively. There were no changes in the trend over time for the incidence of GCG (P>0.05), but a decreasing trend was found for GSC (P 0.05). The age of patients for both GCG and GSC was increasing over time (P<0.05) with a significantly older age observed in GCG than GSC (P < 0.001). Conclusions: The results showed a decreasing trend in incidence for GSC but not GCG and suggested a different tumorigenesis mechanism for cancers in these two different cardiac regions of the stomach in the Chinese patient population. [N A J Med Sci. 2009;2(1):35-38.]","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122131719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thirty-Eight Year Old Asian Female with Breast Cancer","authors":"Grace Perez-Lirio","doi":"10.7156/V1I1P021","DOIUrl":"https://doi.org/10.7156/V1I1P021","url":null,"abstract":"Breast cancer remains one of the most common cancers among women in the United States. The American Cancer Society (ACS) estimates that out of 692,000 cancer cases among women in 2008, 26% is attributed to breast cancer and that 15% of cancer deaths in women are due to breast cancer, second only to lung and bronchial cancer. 1","PeriodicalId":260439,"journal":{"name":"American Chinese Journal of Medicine and Science","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125233284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}